Medi-Cal Billing Specialist
4 weeks ago
Self-Help for the Elderly is seeking a skilled Medi-Cal Billing Specialist to join our team. The ideal candidate will have prior experience in Medi-Cal billing, eligibility verification, and claim status. This role is responsible for completing all claims billing for MSSP services, including Care Management, Care Support, and Waiver Services. The successful candidate will also monitor and review all Waiver Services provided to clients, conduct pre-billing audits to ensure accuracy, and generate reports at the end of month close reflecting revenues, expenses, and accounts receivable and collections. Additionally, the candidate will communicate with the MSSP Team for all billing issues, verify Medi-Cal eligibility for new referrals, manage vendor contracts, and assist with fiscal audits and CDA audits. The ideal candidate will have an Associate degree with an emphasis in Medi-Cal billing, Medi-Cal coding, health information management, or a related field, and great attention to detail, good organizational skills, and ability to manage and prioritize multiple tasks in a fast-paced environment.
Key Responsibilities:
* Completes all claims billing for MSSP services, including Care Management, Care Support, and Waiver Services.
* Monitors and reviews all Waiver Services provided to clients.
* Conducts pre-billing audits to ensure accuracy of documentation.
* Generates reports at the end of month close reflecting revenues, expenses, and accounts receivable and collections.
* Communicates with the MSSP Team for all billing issues.
* Verifies Medi-Cal eligibility for new referrals.
* Manages vendor contracts from contract creation through execution and contract renewal.
* Conducts ongoing analysis to ensure proper vendor performance and cost utilization.
* Assists fiscal audits and CDA audits.
* Assists the Fiscal Dept with deposits, both electronic and actual deposits to the bank.
* Assists with filing and other administrative support duties.
* Attends department and agency meetings.
* Performs other duties as assigned by the CFO.
Requirements:
* Prior experience in Medi-Cal billing, eligibility verification, and claim status is preferred.
* Associate degree with an emphasis in Medi-Cal billing, Medi-Cal coding, health information management, or a related field. May be substituted with one year of task-specific experience.
* Great attention to detail, good organizational skills, and ability to manage and prioritize multiple tasks in a fast-paced environment.
* Excellent verbal and written communication skills and demonstrated business telephone skills.
* Proficient in MS Office and the Internet.
* Must pass a background check.
Self-Help for the Elderly is an Equal Employment Opportunity/Affirmation Action Employer and we welcome diversity in the workplace.
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, age, national origin, sexual orientation, disability, protected veteran status or any other characteristics protected by law.
We participate in E-Verify.
Qualified applicants with criminal history will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.
We may provide reasonable accommodations to applicants with disabilities.
If you need a reasonable accommodation for any part of the application or hiring process, please call (415) for special assistance.
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